Blame Alberta Health Services, blame the government! It's all THEIR fault the ER wait times are out of control. After all, isn't it their fault that the ever more expensive health care system is crumbling? Frankly, it isn't really Alberta Health Services' fault nor the government's. It is Duckett's fault. Duckett and cookie monsters like him. Are YOU eating a cookie right now?
Let me explain my perspective on this. I work for a giant oil company. The shareholders of this oil company all understand that injuries and illnesses are expensive. Very expensive (this is not the official company line). Lost time, incident investigation, impact on share price, retraining, insurance, etc... Fortunately, the shareholders are intelligent people. They figured out how to create a culture in which people think about safety before they do any thing, while they are doing things, and after they are done. Preventing incidents is the number one priority, not for management, but for each and every employee. There are no accidents. Every incident is preventable. You see it, you own it. I've personally asked Vice Presidents to consider not walking while reading a Blackberry so they don't bump into something. Not only do I still work there, they thanked me for the reminder! We are each responsible for ensuring the safety of ourselves and others.
It doesn't end there. Without meddling in people's lives, how can a corporation reduce sick time? Through a health and wellness campaign. Lunchtime fitness and nutrition lectures. A company wide exercise contest. A wellness fair. Flu shots on site. Employee private health check at work. A personal development account that can be used for sports and fitness, health, safety, education and the environment. The list goes on, but I have to tell you a shocking secret: this oil company encourages people to cycle/walk/run to work. It has an enormous bike room and decent shower facilities. Yes, a company that actually sells gasoline and diesel is encouraging its employees to leave their cars at home. Why are they doing this? Healthy employees are more productive, it's cost effective, and aids in employee retention. The company is convinced that it is in it's best interest to care about employees.
So why does it seem that Alberta's Healthcare system doesn't always care for its patients? Essentially, the public are both shareholders in AHS and customers. Citizens put up money in the form of taxes and trust that the healthcare system will be there when they need it. Whenever and where ever they need it, for as long as it takes. No matter what the cause, from heart attacks to sniffles we want service and we want it now. This is where the disconnect happens. Citizens aren't really interested in paying ever increasing taxes to support this utopian health care system. What the people of Alberta demand is more bang for their buck. There are two ways to improve bang without increasing taxes: better management of health care system and reducing demand on the healthcare system.
At the present time, it seems that citizens have little control over the management of the AHS; however, I argue that the bigger bang is in reducing demand on the healthcare system. Increasing demand is one of the main reasons healthcare spending is on the rise. I ask that all citizens put on their AHS shareholder hats and think about what they can do to ensure that taxes for healthcare don't increase. It's not going to be easy. Personal dedication and a cultural shift are required. I know it is possible because my giant oil company is doing it. It will take a little longer and be a little harder, but the citizens of Alberta can make the necessary cultural shift.
Start by thinking about how you can stay out of the ER. Don't just make a list and forget about it. Live it. Own it. It is each citizen's responsibility to look after their own health and the health of others around them. You aren't actually entitled to unlimited healthcare because your fellow Albertans aren't actually willing to pay for that. Bring a veggie tray to the office instead of a box of donuts. Plan to eat a balanced, portioned diet. Exercise regularly. Prevent injury. Relax, have fun and enjoy life. Ask your friends and fellow Albertans to follow your healthy lead. It's that simple folks. If every Albertan does everything they can to be safe and healthy the demand for healthcare will fall. The ER will be available for people who really need it due to unpreventable illness.
Toss your cookies to save Alberta healthcare. Lead the movement to a safe, healthy Alberta. Someone's life depends on it.
Kate, fantastic! It is absolutely refreshing to have your balanced approach to "giant oil" and a paradigm shift in "doing politics differently", thanks for that. Great job!
ReplyDeleteKate - great blog! I completely agree that a culture shift is needed and that we are each responsible for decreasing the demand on the system. The challenge, I believe, is in communicating that necessity to the "entitled" masses. A further challenge is communicating the need for a change in government!
ReplyDeleteIt's hard to disagree that many users abuse the system and that this results in inflated costs. I'm sure we all know people who routinely go to the doctor for every minor ailment. Certainly a culture shift would help to resolve this particular issue.
ReplyDeleteI'm not sure this is necessarily the biggest issue with the system however. There is a huge amount of waste in the bureaucracy of our healthcare system.
A couple of years ago I consulted for an administrative health care agency. This was a truly shocking experience. This organization receives millions of dollars in annual funding from the government and is one of eight such organizations in Calgary alone.
At the time they had three or four sources of funding all of which were intended for specific purposes. They had no financial accounting system. They had one bank account. When asked how they keep track of which funds are used for which purposes, they explained that they just estimate it at the end of the year. When asked if they were required to pass audits, we were informed that yes they were, and they have passed every year they have been in existence. How this is possible I'm not sure.
This is a multi-million dollar organization funded one hundred percent by the taxpayer. They used a spreadsheet to keep track of their finances. In all the companies I have worked with in the private sector I have never seen anything quite like this.
The problems were not just with the finances either. When we were asked to work with them to provide some metrics for their annual report, we asked what exactly they were after. Nobody in the organization could tell us. Not even the director knew what they were supposed to be measuring, what the board was looking for in the annual report. At the time this organization had existed for a number of years and they didn't even have a clear understanding of their mandate.
This is just one example of a system that is utterly disorganized and lacking in leadership. I have also heard first hand from a doctor in private practice who just secured a position advising other doctors on how to extract the most money from the system. That's right, he gets paid to advise other doctors how they can use the system against itself to maximize profit for themselves. This is a broken system.
It seems that every government that comes into power dismantles the system they inherited and installs their own ramshackle regime. Staff at all levels are constantly in disarray, working for a different boss and a different mandate and wondering for how long they will have a job. This is not fixing anything.
I believe that a well organized, efficiently run organization could conceivably provide us with a first rate health care system with the same budget we have now. The question is, how do we get there?
I didn't know you had a blog!
ReplyDeleteI totally agree with your position about prevention. A true health care system should have at least as much focus on creating and maintaining a healthy population, as opposed to the sick-care system we have now. Too many people feel that they have a right to on-demand health care, without having the corresponding responsibility to live a healthy lifestyle.
So true Kate, coupled with a focus on wellness in AHS, rather than 'sick care' citizens may well rely less on the need for a hospital bed. However, reading the sad state of affairs outlined by johnnyfever it seems we all have a bigger obstacle to get over... Where in the oath Dr.s take does it say: "I will use my precious knowledge to train others on how to make more money while my patients sit waiting in the lobby?"
ReplyDeleteI agree with your assessment that we should be trying to focus on prevention. The problem is, that as long as the system is "free", people have little incentive because they can't connect their tax rate directly to the health care system. The pricing mechanism of the free market (the invisible hand) could be a powerful motivator.
ReplyDeleteThanks for your comment, Taliesyn. While I agree that people find it difficult to connect their taxes with the need to prevent health problems, I don't think free market pricing helps either. The problem is mostly that the consequences of poor diet and lack of exercise are not immediate. It's not like you eat a chocolate bar and then come down with diabetes. People have trouble believing that their behaviour is a problem until it is too late. If a free market health care system actually motivated people, then why are there all kinds of preventable health problems in people who can't afford medical care in the US?
ReplyDeleteYou make a valid point that there is no immediacy. Perhaps some small influence of market forces could reduce some waste in the system. One of the problems in the US system is that the insurance industry doesn't properly penalize policy holders for poor health behaviour, other than smoking and "pre-existing" conditions - largely because they cannot "prove" certain causality of obesity or sedentary lifestyles to problems. I know that I might spend more time and effort on my "wellness" if I knew the impact to my pocketbook was an annual or monthly affair and that getting healthier could reduce it.
ReplyDeleteIf health care costs won't motivate people to exercise, perhaps vanity will: http://www.theglobeandmail.com/news/opinions/editorials/a-simple-way-to-stave-off-infirmity/article1824780/
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